Virtual Reality Functional Capacity Assessment Tool (VRFCAT-SL) in Parkinson's Disease.

Travis H Turner,Alexandra Atkins,Richard S.E Keefe

doi:10.3233/jpd-212688

Abstract

Background:Cognitive impairment is common in Parkinson’s disease (PD) and highly associated with loss of independence, caregiver burden, and assisted living placement. The need for cognitive functional capacity tools validated for use in PD clinical and research applications has thus been emphasized in the literature. The Virtual Reality Functional Capacity Assessment Tool (VRFCAT-SL) is a tablet-based instrument that assesses proficiency for performing real world tasks in a highly realistic environment.Objective:The present study explored application of the VRFCAT-SL in clinical assessments of patients with PD. Specifically, we examined associations between VRFCAT-SL performance and measures of cognition, motor severity, and self-reported cognitive functioning.Methods:The VRFCAT-SL was completed by a sample of 29 PD patients seen in clinic for a comprehensive neuropsychological evaluation. Fifteen patients met Movement Disorders Society Task Force criteria for mild cognitive impairment (PD-MCI); no patients were diagnosed with dementia. Non-parametric correlations between VRFCAT-SL performance and standardized neuropsychological tests and clinical measures were examined.Results:VRFCAT-SL performance was moderately associated with global rank on neuropsychological testing and discriminated PD-MCI. Follow-up analyses found completion time was associated with visual memory, sustained attention, and set-switching, while errors were associated with psychomotor inhibition. No clinical or motor measures were associated with VRFCAT-SL performance. Self-report was not associated with VRFCAT-SL or neuropsychological test performance.Conclusion:The VRFCAT-SL appears to provide a useful measure of cognitive functional capacity that is not confounded by PD motor symptoms. Future studies will examine utility in PD dementia.

Highlights

Parkinson’s disease (PD) is a progressive neurodegenerative disorder involving both motor and non-motor symptoms
Boxplots illustrating ranges for Virtual Reality Functional Capacity Assessment Tool (VRFCAT)-SL outcome measures relative to standardized neuropsychological test performances are provided in Supplementary Figure 2
A modest correlation was observed between composite ranks for overall VRFCAT-SL and standardized neuropsychological measures

Summary

Introduction

Parkinson’s disease (PD) is a progressive neurodegenerative disorder involving both motor and non-motor symptoms. Neuropsychological evaluations are useful for determining whether subjective reporting of decline in memory and cognition by the patient is supported by objective findings of deficits on standardized tests [5]. Impairment on a test of verbal fluency may relate to word-finding difficulties in conversation [7] Such associations are certainly not perfect, and the need for ecologically valid measures of functional ability have been emphasized in the literature [8,9,10]. Cognitive impairment is common in Parkinson’s disease (PD) and highly associated with loss of independence, caregiver burden, and assisted living placement. Non-parametric correlations between VRFCAT-SL performance and standardized neuropsychological tests and clinical measures were examined.

Objectives

Results

Conclusion